Ten year outcomes of participants in the REACT (Randomised Evaluation of Assertive Community Treatment in North London) study (BMC Psychiatry)

Background: A previous randomised controlled trial that investigated Assertive Community Treatment (ACT) in the UK (the REACT Study) found no clinical advantage over usual care delivered by Community Mental Health Teams (CMHTs) at 18 and 36?month follow-ups. No studies have investigated long term clinical and social outcomes for patients receiving ACT.MethodWe investigated inpatient service use, social outcomes, service contact and adverse events for the 251 REACT study participants 10?years after randomisation through case note review. Data were analysed using regression models adjusted for original treatment group allocation and changes in treatment group. Results: We found no statistically significant differences in outcomes by original treatment group over the 10?years. Those whose care remained with ACT, or transferred to ACT or forensic services, had more inpatient days over the 10?years (coefficient 223, 95% CI 83 to 363, p =0.002) than those whose care remained with the CMHTs or were discharged to primary care. Being subject to a Community Treatment Order was associated with a greater chance of being under ACT at 10?year follow-up (OR 6.39, 95% CI 2.98 to 13.70, p